Home / PUBLIC HEALTH PROJECT TOPICS AND MATERIALS / KNOWLEDGE, ATTITUDE AND PERCEPTION OF NOSOCOMIAL INFECTION AMONG HEALTH WORKERS AND RESIDENT OF EGOR L.G.A IN EDO STATE, NIGERIA

KNOWLEDGE, ATTITUDE AND PERCEPTION OF NOSOCOMIAL INFECTION AMONG HEALTH WORKERS AND RESIDENT OF EGOR L.G.A IN EDO STATE, NIGERIA

KNOWLEDGE, ATTITUDE AND PERCEPTION OF NOSOCOMIAL INFECTION AMONG HEALTH WORKERS AND RESIDENT OF EGOR L.G.A IN EDO STATE, NIGERIA

Format: Ms Word Document| Pages: 101|Price: N 5,000| Chapters: 1-5

GET THE COMPLETE MATERIAL

INTRODUCTION

Nosocomial or hospital acquired infections (HAIs) is a serious global public health issue, causing the suffering of about 1.4 million people across the world at any given time (WHO 2007). Susceptibility to these infections has been associated with use of invasive devices, extremes of age, immune status and infection control practices (Haley et al 1985, Emori and Gayness 1995, Vincent et al 1995).They often increase costs of health care both for patients and health services alike (Coello et al 1993, McCuckin et al 1999, Kim et al 2001). The World Health Organization offers several definitions of a nosocomial infection/ hospital –acquired infection:

An infection acquired in [a] hospital by a patient who was admitted for a reason other than that infection . An infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility.

As a general timeline, infections occurring more than 48 hours after admission are usually considered nosocomial.  Nosocomial infections are also divided into two classes, endemic or epidemic. Most are endemic, meaning that they are at the level of usual occurrence within the setting. Epidemic infections occur when there is an unusual increase in infection above baseline for a specific infection or organism. Epidemiological studies report that nosocomial infections are caused by ubiquitous. pathogens such as bacteria (Lepelletier et aI., 2005), viruses (de-Oliveira et aI., 2005) and fungi(Trick et aI., 2002) present in air, surfaces or equipment. Nosocomial infections occur worldwide, both in the developed and developing world.  They are a significant burden to patients and public health.  They are a major cause of death and increased morbidity in hospitalized patients.  They may cause increased functional disability and emotional stress and may lead to conditions that reduce quality of life.  Not only do they affect the general health of patients, but they are also a huge burden financially.   The greatest contributors to these costs are the increased stays that patients with nosocomial infections require.  The increased length of stay varies from 3 days for gynecological procedures to 19.8 days for orthopedic procedures.  Other costs include additional drugs, the need for isolation, and the use of additional studies.  There are also indirect costs due to loss of work.

Nosocomial infections are most frequently infections of the urinary tract, surgical wounds, and the lower respiratory tract.  A World Health Organization prevalence study and other studies have shown that these infections most commonly occur in intensive care units and in acute surgical and orthopedic wards.  Infection rates are also higher in patients with increased susceptibility due to old age, underlying disease, or chemotherapy.

Patients are exposed to a variety of microorganisms during a hospital stay, but contact between a patient and an organism does not necessarily guarantee infection.  Other factors influence the nature and frequency of infections.  Organisms vary in resistance to antimicrobials and in intrinsic virulence.  Bacteria, viruses, fungi, and parasites can all cause nosocomial infections.  There are multiple ways of acquiring such an organism.  The organisms can be transferred from one patient to another (cross-infection).  They can be part of a patient’s own flora (endogenous infection).  They can be transferred from an inanimate object or from a substance recently contaminated by another human source (environmental transfer).  The organisms that cause most hospital acquired infections are common in the general population, in which setting they are relatively harmless.  They may cause no disease or a milder form of disease than in hospitalized patients.  This group includes Staphylococcus aureus, coagulase-negative staphylococci, enterococci, and Enterobacteria.  Factors that increase a patient’s susceptibility to nosocomial infections include young or old age, decreased immune resistance, underlying disease, and therapeutic and diagnostic interventions.

The organisms that cause nosocomial infections are often drug-resistant.  The regular use of antimicrobials for treatment therapy or prophylaxis promotes the development of resistance.  Through antimicrobial-driven selection and the exchange of genetic resistance elements, multi-drug resistant strains of bacteria emerge.  Antimicrobial-sensitive microorganism that are part of the endogenous flora are suppressed, while the resistant strains survive.  Many strains of pneumococci, staphylococci, enterococci, and tuberculosis are currently resistant to most or all antimicrobials which were once effective.
Health care workers (HCWs) are at a high risk of needle stick injuries and blood-borne pathogens as they perform their clinical activities in a hospital.3  They are exposed to blood borne pathogens, such as human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses, from sharp injuries and contacts with blood and other body fluids.

Many nosocomial infections are caused by pathogens transmitted from one patient to another, by way of healthcare workers who have not washed their hands, or who don’t observe simple hospital hygiene measures, and also between patients (Horn et al 1988). Consequently, it is important to note that approximately one-third of hospital-acquired infections may be preventable (Comptroller and Auditor General 2000)

 

Statement of the Problem
Healthcare workers (HCWs) are at menace of occupational hazards as they carry out their clinical activities in the hospital.  Nosocomial infections have been acknowledged as a problem disturbing the quality of health care and a principal source of adverse healthcare outcomes. It has been recognized in the literature that within the realm of patient safety, these infections have serious impact. Increased hospital stay days, increased costs of healthcare, economic destitution to patients and their families and even deaths, are among the many negative outcomes (Emori et aI., 1991; Starfield et aI.,2000; Angus et aI., 2001; Zhan &Miller, 2003; CDC, 2005; Engemann et aI., 2005; Elward, et aL, 2005: Klevens et aL, 2007; Kaye et aL, 2009; Edwards et aI., 2009; Scott II, 2009). $26 million (Anderson et aI., 2009). These findings are indicative of the enormous economic burden associated with nosocomial infections.

Epidemiological studies report that nosocomial infections are caused by ubiquitous pathogens transmitted, at least in part, by healthcare workers through direct and indirect contact.

In 1938, Price established that microorganisms recovered from human body could be divided into two categories: the resident Hora (microbiota), or transient flora (Price, 1938). The resident

microbiota, also commonly referred to as normal flora consists of bacteria mostly found in the

superficial cells of the skin and mucous membranes; and in linings of the orifices of digestive, respiratory and reproductive systems (Black, 2012). It has been demonstrated in several immunological studies that resident microbiota exhibits protective functions against invasion, or

outgrowth, of pathogenic microorganisms and its depletion or aberration may lead to opportunistic infections (Fujimura et aI., 2010). However, these bacteria may cause infections in non-intact skin.

The most overriding species of resident microbiota is Staphylococcus epidermidis.

Transient microbiota are microorganisms present, under definite conditions, in any of the

locations where resident microbiota are found. Some of these microorganisms take possession of the superficial layers of the skin. They are more amenable to removal by routine hand hygiene and such microorganisms are often acquired by healthcare workers during direct contact with patients or contaminated environmental surfaces, within the patient’s surroundings. The most common types of transient bacteria are the Staphylococcus aureus, Escherichia coli, {3eta-hemolyticStreptococci, Serratia mercescens, Klebsiella pneumoniae, Pseudomonas aeruginosa,

Enterobacter species, Candida albicans and Clostridium difficile (Black, 2012). These are the

organisms frequently implicated in nosocomial infections (Monarca et aI., 2000; CDC 2002;

Lepelletier, 2005; Ribby et aI., 2005 &Hayden et al., 2006) and some of the strains are resistant to antibiotics (Lodise et aI., 2002; Conly et aI., 2004; Abba et al., 2005).

Epidemiological studies have demonstrated that transient bacteria are often acquired by

healthcare workers during direct contact with patients, or contaminated environmental surfaces,

within the patient’s surroundings (Monarca et aI., 2000; Lepelletier, 2005; Ribby et aI., 2005 &

Hayden et aI., 2006). Epidemiological studies suggest that nosocomial infections can be transmitted through direct person-to- person contact between infected patient. healthcare workers, non-infected patients and by indirect contact through equipment, supplies, medical procedures, or air (CDC, 2000; WHO 2002). The affected body systems depend on the virulence of the pathogens, accessibility of the pathogen to the patient and susceptibility of the patient to the pathogen (CDC, 2000). The most common types of nosocomial infections affect the urinary tract, surgical wounds, respiratory system and blood stream (WHO, 2002). Studies that have examined the impact of nosocomial infections caused by antibioticresistant pathogens at a single center in Egor L.G.A  and some laboratories that served hospitals in Edo state, showed that infections caused by antibiotic challenging pathogens were associated with amplified mortality rates, increased lengths of hospital stay and higher healthcare costs compared to the nosocomial infections caused by pathogens susceptible to antibiotics.

These findings sustain the notion that nosocomial infections present massive economic encumber to the public and the healthcare system.  In response to the realization of the degree of the problem, various agencies including federal and state governments, and professional societies – both nationally and internationally, have devised measures aimed at reducing the incidence of nosocomial infections. For example, Center for Infection Control and Epidemiology developed guidelines for hand-hygiene in healthcare settings and made recommendations for infection control practices which were based upon the obtainable evidence surrounding the best practices for patient care (Boyce at aI., 2002).

Furthermore, the Centers for Disease Control and Prevention (CDC), in cooperation with

government and non-government organizations throughout the world, has synchronized efforts and resources to help minimize the occurrence of nosocomial infections; and recommend activities that increase quality of patient care. In this regard, healthcare workers have been fostered to implement strategies that would call attention to measures aimed at prevention of the transmission of nosocomial infections. For that reason, healthcare professionals have been encouraged to participate in in-service continuing education on topics related to measures deemed necessary to reduce the transmission of nosocomial infections.

The World Health Organization (WHO), in conjunction with CDC, set prevention of nosocomial infections as main concern by developing a practical guide (manual) for the prevention of nosocomial infections globally (WHO, 2002). Some recommended strategies included in the manual were: the use of hand decontamination, personal hygiene, exploitation of masks and gloves; and proper methods of handling soiled clothing when healthcare workers perform patient care activities. The manual also recommends methods for preventing environmental transmission

including cleaning the hospital environment, use of hot  superheated water, disinfection of patient equipment, sterilization, and prevention of transmission of pathogens (for example, HIV, Hepatitis- B, Hepatitis-C viruses, and M. tuberculosis) to staff. Above a/l, the manual recommends that hospitals provide sufficient resources by training staff in infection control programs such as appropriate patient isolation and sterilization techniques and yearly work-plans and manuals for infection control practices that are approved by infection control committees (WHO, 2002). Such initiatives by the CDC suggest the importance with which nosocomial infections should be addressed (http://www.cdc.gov/ncidodlhip/prevention). Conversely, despite the development of the above policies and recommendations, the incidence of nosocomial infections and their collision on healthcare costs, morbidity and mortality stay unabated (Anderson et aI., 2009 &Scott II, 2009)  and healthcare workers are concerned in the transmission. The centers for Medicare and Medicaid Services instituted a“payment reform” program  where the eventual reimbursement system will not cover costs for preventable infections (nosocomial infections) acquired in the course of treatment (Johnson, 2009). Moreover, the federal government requires that healthcare institutions’ statistics on nosocomial infections be made available to the public and hospitals with highest rates of nosocomial infections will be penalized (DHHS, 2009). Furthermore, the Healthcare Reform Law has instituted measures that incentivize hospitals and other healthcare facilities to improve their programs for reducing nosocomial infections. Findings from several epidemiological studies divulge that healthcare workers such as physicians, dentists and nurses are implicated in the transmission of nosocomial infections.

It has as well been reported that transmission frequently occurs during the performance of medical procedures, when these healthcare workers fail to follow aseptic precautions. Thus, noncompliance with recommended guidelines by healthcare workers expose patients to an abundance of pathogens (Monarca et aI., 2000; Boyce et aI., 2002; Cohen et aI., 2003; Harrel et aI., 2004; Pittet et aI., 2004; Miner et aI., 2004; Szymanska, 2004; de Oliveira et aI., 2005; Lam et aI., 2004; Kurita et aI., 2006; Rautemaa et aI., 2006; Racco et aI., 2009; Eriksen et aI., 2009 &Costello et aI.,2010).

A study conducted by Casewell and Philips (1977) demonstrated that nurses could contaminate their hands with colonies of bacteria during clean patient care activities such as lifting patients, taking pulse, blood pressure, oral temperature or touching patients’ hands, shoulder or groin (Casewell and Phillips, 1977). Stone (2001) documented that patient contacts result in 18

contamination of hands by pathogens and that washing hands significantly reduces hand

contamination and infection rates (Mortimer et al., 1966; Stone, 2001). In a controlled trial study at a neonatal unit, Mortimer and colleagues (1966) found only 10 %acquisition rate of Staphylococcus aureus by babies where nurses washed their hands between patient contacts; and a 14% acquisition rate of the same pathogen by babies during the first 20 days when the nurses

washed their hands between patient contacts. The rate increased to 43% when the nurses

washed their hands only when they felt that the practice was clinically indicated (Mortimer et aI., 1966). These findings affirmed the ease with which healthcare workers could transmit

microorganisms and consequently, the spread of nosocomial infections.

Price (1938) and Lepelletier et al. (2005) observed that transient bacteria that colonize the

superficial layers of the skin are easily acquired by healthcare workers during direct contact with

patients or contaminated environmental surfaces (Price, 1938 &Lepelletier et aI., 2005). likewise, McBryde et al. (2004) and Michalopoulos et al. (2006), recognized that healthcare workers contaminate their hands or gloves with various pathogens, including resistant strains. While performing procedures that involve touching hospitalized patients’ intact skin or their immediate environment. Exclusively, 17% of transmission of Methicillin Resistant Staphylococcus aureus(MRSA) to the healthcare workers’ gloves occurred after get in touch with patients, patients’ clothing or patients’ bed (McBryde et aI., 2004). additional studies that investigated the modes of transmission of nosocomial infections in neonatal intensive care units showed that each hospitalized neonate or its immediate environment was touched 78 times during a 12-hour shift. Explicitly, more than half of the contacts were carried out by nurses (Cohen, et aI., 2003). In the light of these statistics, it is incumbent upon healthcare workers to enhance their knowledge of options as regards the alleviation of the transmission of nosocomial infections. It has been documented in the literature that at the time of their graduation from their

professional education programs, nurses should have acquired sufficient knowledge to practice

patient safety and infection control guidelines (Smith et aI., 2007; Cronenwett et aI., 2007).

Besides, their expertise with regards to knowledge, attitudes and practice to control the spread

of infection is also well evidenced by their success in licensure exams and other significant

assessments, which test their knowledge of infection control practices and the application of skilled safe patient care activities, over the course of their academic journey (Sherwood et aI., 2007; Smith, 2007). hence, the continued presence of nosocomial infections raises an enigma which may only be explained by other factors. fascinatingly, studies that investigated the responsibility of institutional support and the spread of nosocomial infections showed that low staffing levels lead to high workload and increased healthcare workers’ non-compliance with recommended hand hygiene practices (Huggonet et aI., 2007). Furthermore, existing studies show that the lack of proper equipment and surveillance systems for the monitoring of infections further increased the episodes of nosocomial infections (Monarca et aI., 2000; Chen et aI., 2003, Garretson et aI., 2004; Lo et aI., 2008 & Saint et aI., 2008). Thus, it is plausible that this paradox could be explained through a thorough examination of socio-cognitive perspectives with regards to knowledge; or behavioral aspects such as attitude that could affect the healthcare workers’ on-the- job practice; or ecological factors that include organizational support or architectural design of healthcare facility.

 

GET THE COMPLETE MATERIAL

About admin

Check Also

JUVENILE DELINQUENCY, CAUSES AND PREVENTION

LEVEL OF AWARENESS ON THE PREVENTION OF ANEAMIA AMONG PREGNANT WOMEN IN IBESIKPO ASUTAN LOCAL GOVERNMENT AREA OF AKWA IBOM STATE.

LEVEL OF AWARENESS ON THE PREVENTION OF ANEAMIA AMONG PREGNANT WOMEN IN IBESIKPO ASUTAN LOCAL …

PUBLIC HEALTH, FACTORS AFFECTING FAMILY PLANNING SERVICS IN RURAL AREA AMONG WOMEN (A CASE STUDY OF NSIT IBOM LOCAL GOVERNMENT AREA OF AKWA IBOM STATE)

FACTORS AFFECTING FAMILY PLANNING SERVICS IN RURAL AREA AMONG WOMEN (A CASE STUDY OF NSIT IBOM LOCAL GOVERNMENT AREA OF AKWA IBOM STATE)

FACTORS AFFECTING FAMILY PLANNING SERVICS IN RURAL AREA AMONG WOMEN (A CASE STUDY OF NSIT …

Public heath topics and materials, Health Benefits of Ewedu Leaf, Download public heath topics and materials, Public heath topics and materials

Health Benefits of Ewedu Leaf

NANPA HEALTH TIPS OF THE DAY JUTE LEAF (EWEDU) Ewedu leaf as the Yoruba’s call …

free final year mass communication project topics and material, THE IMPACT OF RADIO AND VOTER EDUCATION IN NIGERIA (A CASE STUDY OF FRCN IKOYI LAGOS STATE)

THE IMPORTANCE OF RHESUS FACTOR IN MARRIAGE AND CHILD BIRTH

THE IMPORTANCE OF RHESUS FACTOR IN MARRIAGE AND CHILD BIRTH   ASIDE KNOWING YOUR GENOTYPE …

THE CONCEPT OF FEMINISM IN BUCHI EMECHETA’S SECOND CLASS CITIZEN AND OKOYE IFEOMA’S BEHIND THE CLOUDS

CAUSES AND EFFECTS OF COMMUNICATION BREAKDOWN IN AN ORGANIZATION

CAUSES AND EFFECTS OF COMMUNICATION BREAKDOWN IN AN ORGANIZATION Format: Ms Word Document| Pages: 75|Price: N …

LAW PROJECT TOPICS AND MATERIALS, AN ASSESSMENT OF THE PRIVATISATION AND COMMERCIALISATION LAW AND GUIDING PRINCIPLE IN NIGERIA

THE NIGER DELTA CRISIS: IT’S IMPACT ON NIGERIAN’S NATIONAL SECURITY

THE NIGER DELTA CRISIS: IT’S IMPACT ON NIGERIAN’S NATIONAL SECURITY Format: Ms Word Document| Pages: 103|Price: N …

Leave a Reply

Your email address will not be published. Required fields are marked *